On pure tone audiometry, a patient's air conduction threshold is 55 dB HL and bone conduction threshold is 30 dB HL in the same ear. The air-bone gap is 25 dB. This configuration is most consistent with:

• A Pure sensorineural hearing loss
• B Pure conductive hearing loss
• C Mixed hearing loss ✓
• D Functional hearing loss

Explanation

Mixed hearing loss is defined by the presence of both a sensorineural component (bone conduction threshold elevated above normal, i.e., >25 dB HL) and a conductive component (air-bone gap present, i.e., AC > BC by more than 10 dB). Here, BC = 30 dB HL (abnormal — SNHL component) and AC = 55 dB HL with a 25 dB air-bone gap (conductive component). Both components coexist, confirming mixed loss.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.